妇科恶性肿瘤根治术后发生下肢深静脉血栓的高危因素及保护因素的研究  

Study of high-risk and protective factors of low extremity deep venous thrombosis after radical surgery for gynecological malignant tumors

作　　者：周其印 王东红[1] 张振东[1] 邹焰[2] 明祖谦[1] 李娜[1] 安强[1] 刘毅[1] 林振江[1] 江飞[1] 

机构地区：[1]遵义医学院第一附属医院妇科,贵州遵义563003 [2]遵义医学院第一附属医院预防医学教研室,贵州遵义563003

出　　处：《中国妇幼保健》2016年第22期4671-4674,共4页Maternal and Child Health Care of China

摘　　要：目的探讨妇科恶性肿瘤根治术后发生下肢深静脉血栓(LEDVT)的高危因素和保护因素。方法收集实施妇科恶性肿瘤根治术患者122例,分为研究组(发生LEDVT组)及对照组(未发生LEDVT组)各61例。比较两组间共19个因素的临床资料,分析高危因素和保护因素。结果 LEDVT在各疾病组间发生率的差异无统计学意义(P>0.05)。单因素分析显示,体重指数、术中失血量、术后连续卧床时间、术后血小板总数、术后凝血酶原时间(PT)、术后活化部分凝血活酶时间(APTT)、术后纤维蛋白原(FIB)在两组间的差异均具有统计学意义(P<0.05)。多因素分析显示,术后血小板总数及PT的差异无统计学意义(P>0.05)。术后APTT、体重指数、术中失血量、术后连续卧床时间、术后FIB与LEDVT的发生具有相关性OR=0.105、3.421、4.975、6.584、8.19,P<0.05)。结论 1体重指数、术中失血量、术后连续卧床时间、术后FIB与妇科恶性肿瘤根治术后LEDVT的发生呈正相关,可能是LEDVT的高危因素,其中术后FIB可能是LEDVT重要的影响因素。2术后APTT与LEDVT的发生呈负相关,提示术后APTT>27.55s可能是LEDVT的保护因素。Objective To explore the high-risk factors and protective factors of low extremity deep venous thrombosis （LEDVT） after radical surgery for patients with gynecological malignant tumors. Methods A total of 122 patients undergoing radical surgery for gynecologi- cal malignant tumors in the First Affiliated Hospital of Zunyi Medical College were collected, then they were divided into study group （ LED- VT group） and control group （ non-LEDVT group）, 61 patients in each group. The clinical data of 19 factors related to LEDVT were com- pared between the two groups, the high-risk and protective factors were analyzed statistically. Results There was no statistically significant difference in the incidence rate of LEDVT among the patients with different types of gynecological malignant tumors （P〉0. 05） . The results of univariate logistic analysis showed that there were statistically significant differences in body mass index （BM!）, the amount of intraoperarive blood loss, postoperative continuous time in bed, postoperative platelet count, postoperative prothrombin time （PT）, postoperative acti- vated partial thromboplastin postoperative time （ APTF）, and postoperative fibrinogen （FIB） level between study group and control group （ P〈0.05 ） . The results of multivariate logistic analysis showed that there was no statistically significant difference in postoperative platelet count and postoperative PT between study group and control group （P〉0. 05 ） . Postoperative APTT, BMI, the amount of intraoperative blood loss, postoperative continuous time in bed, and postoperative FIB level were correlated with the occurrence of LEDVT （OR = 0. 105, 3. 421, 4. 975, 6. 584, 8. 19, respectively, P〈0. 05） . Conclusion BMI, the amount of intraoperative blood loss, postoperative continuous time in bed, and postoperative FIB level are positively correlated with LEDVT after radical surgery for patients with gynecological malignant tumors, which may be high-rlsk factors of LEDVT, postoperat

关 键 词：妇科 恶性肿瘤 肿瘤根治术 下肢深静脉血栓 影响因素 

分 类 号：R654.4[医药卫生—外科学]